胆囊上皮癌变病理形态学与CD44基因蛋白表达  

Expression of CD44 and patho-morphology in gallbladder epithelium cancerization

作　　者：王仰坤[1] 马乃绪[2] 郭念凯[2] 宋景华[2] 王德文[3] 

机构地区：[1]解放军第150中心医院病理科,洛阳471031 [2]解放军第91医院,兖州272000 [3]军事医学科学院放射医学研究所,北京100853

出　　处：《肝胆胰外科杂志》2002年第1期46-48,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的 :研究慢性胆囊炎、胆囊腺上皮异型增生到癌变过程中形态及其与CD4 4基因表达的关系。方法 :采用病理组织学和免疫组织化学S P法检测 95例慢性胆囊炎、慢性胆囊炎壁肥厚伴腺上皮异型增生和胆囊炎后壁肥厚型腺癌的CD4 4基因表达。结果 :胆囊壁增厚者粘膜上皮部分或大部分脱失 ,形成代偿性区域性增生集中 ,伴有不同程度的异型性。CD4 4基因蛋白在慢性胆囊炎中均为阴性表达 ,胆囊壁肥厚伴腺上皮异型增生Ⅰ级、Ⅱ级和Ⅲ级的表达分别为 18.8%、2 1.4 %和 2 7.3% ,结果显示 :胆囊炎壁肥厚随着腺上皮异型增生程度加重 ,而CD4 4基因蛋白阳性表达率随之递增。慢性胆囊炎后壁肥厚型腺癌CD4 4阳性表达为5 7.1% ,阳性强度增加 ,阳性细胞数增多。结论 :胆囊壁肥厚是重要的癌前病变 ,胆囊壁肥厚或增厚的结节在1.5cm以上者应采取手术切除。Objective:To study the relation between expression of CD44 and gallbladder glandular epithelium proliferation to cancerization.Methods:Histopathology and immunohistochemistry were applied in the detection of the rate of expression of CD44 in 95 cases with chronic cholecystitis and its posterior wall plump adenocarcinoma.Results:A majority of mucous membrane epithelium was exfoliated in plump gallbladder wall and formed into regional compensatory hyperplasia concentration accompanied with various degrees of atypia. CD44 was not expressed in the chronic cholecystitis,but it is positive respectively at 18.8%,21.4% and 27.3% in the stage Ⅰ,stage Ⅱ,stage Ⅲ of atypical proliferation of gallbladder glandular epithelium. With the aggravation of glandular epithelium atypia proliferation,the number of positive cells increased. CD44 was positive at 57.1% chronic cholecystitis posterior wall pachismas type adenocarcinoma.Conclusion:Plump gallbladder wall is important precancerous lesion,which should be resected when the node size exceeds 1.5 cm.

关 键 词：胆囊炎 异型增生 癌前病变 病理学 蛋白质CD44 免疫组织化学 

分 类 号：R735.8[医药卫生—肿瘤]